196 Dengue Fever. 



Dengue Fever. This disease of man occurs in the tropics, espe- 

 cially in Anu-riea, East Indies and on the coast of the Mediterranean. 

 It sometimes is very widely distributed, and is characterized by suddenly 

 appearing chills, pains in the joints and muscles (dengue-dandy, so called 

 from tlie peculiar stiff gait as the result of pain in the knee joints), 

 further in a polymorphous, exanthema of the skin. According to some 

 observers (DeBrun, Cubillas, Martialis), the disease also occurs among 

 domestic aninuds. Piot-Bey observed in 1895, in Egypt, enzootic 

 affection of cattle which he identified with dengue fever. The animals 

 suddenly became att'ected with a striking muscular weakness, which 

 was so marked that they staggered and trem])led in walking, or becom- 

 ing exhausted they lay down on the chest. The body temperature was 

 moderately elevated (39.5 to 39.6'' C), respiration and pulse accel- 

 erated (25 to 30, and 60 to 90 per min.). At the same time there was 

 complete inappetence and constipation. Usually after three to four 

 days diarrhea appeared, which was soon followed in all cases by 

 complete recovery. (Fievre dengue sur I'espece bovine, Extrait du 

 Bull, de rinst. Egyptien, Le Caire, with literature). 



Three Days' Sickness, Stiff Sickness, Ephemeral Fever. In South 

 Africa there occurs a disease among cattle which Schweinfurth observed 

 in 1867, but to which the attention of the experts has only in receiit 

 years been directed, when it spread extensively in Rhodesia, in the 

 Transvaal, Natal and in the Cape Colonies. It was first demonstrated 

 in November, 1906, by Edmonds, and later described by Bevan, Theiler 

 and Freer (it is possibly identical with dengue fever). 



The symptoms in the majority of cases develop and disappear 

 within three days, or the disease may terminate in death. Manifesta- 

 tions are, stiffness of the muscles of one or all extremities, extending 

 to the neck, or even over the entire body. As a result of this condition 

 the animals are lame, and later they are hardly able to move and seem 

 obliged to lie helplessly on the ground. Development of this condition 

 is preceded by climinishing appetite and rumination, and also by an 

 elevation of the body temperature, while later on there appears a 

 conjunctivitis, with swelling of the parts surrounding the eyes, fre(iuent 

 respiration, very weak pulse, distinct veinous pulse and constipation. 

 The termination is usually favorable, as not more than 3% of the 

 affected animals succumb, and part of these as a result of inhalation 

 pneumonia. 



The cause of the disease is unknown at the present time, but 

 Robertson and Theiler showed that it may be transmitted with the 

 ])lood of affected animals, in which case the symptoms develop after 

 an incubation of from 2 to 3 days. It is possil)le that the infection is 

 communicated by insects (mosquitoes?). Animals which have recovered 

 from the disease ac<iuire an immunity wiiich only lasts aliout six w^eeks 

 (Robertson), reinfections being therefore not infre(|uently observed 

 (Freer). 



Literature. Bevan, J. of eomp. Path., 1907, XX, 104.— Theiler, Rep. of 

 the Transvaal Gov. Bact., 1907.— Freer, V. J., 1910, 19. 



Malta Fever. (IMediterranean Fever.) Malta fever is a febrile 

 disease of man, wliich most fre(|uently occurs on the Island of Malta, 

 then in the countries around the IMediterranean Sea, and probably 

 also in other tropical countries. The disease is very protracted, remit- 

 tent in its course, and associated wdth anemia, headaches, rheumatic 

 difficulties, constipation, and swelling of the joints. A fatal termination 



